Harlem Health Advocacy Partners: A Local Health Department's Place-Based Community Health Worker Program.

In January 2015, the New York City Department of Health and Mental Hygiene launched Harlem Health Advocacy Partners (HHAP), a place-based initiative to demonstrate the capacity of a CHW workforce to improve the health of residents of public housing. The long-term goal of HHAP is to improve the population health of residents of public housing in East and Central Harlem and to close racial gaps in health and social outcomes. A variety of evaluation approaches have been used to assess the initiative. This paper describes the HHAP model and methods for evaluating the program.

Combination therapy of Epidermal Growth Factor and Growth Hormone-Releasing Hexapeptide in acute ischemic stroke: a phase I/II non-blinded, randomized clinical trial.

Objective: This study tested the hypothesis that a neuroprotective combined therapy based on epidermal growth factor (EGF) and growth hormone-releasing hexapeptide (GHRP6) could be safe for acute ischemic stroke patients, admitting up to 30% of serious adverse events (SAE) with proven causality. Methods: A multi-centric, randomized, open-label, controlled, phase I-II clinical trial with parallel groups was conducted (July 2017 to January 2018). Patients aged 18-80 years with a computed tomography-confirmed ischemic stroke and less than 12 h from the onset of symptoms were randomly assigned to the study groups I (75 µg rEGF + 3.5 mg GHRP6 i.v., n=10), II (75 µg rEGF + 5 mg GHRP6 i.v., n=10), or III (standard care control, n=16). Combined therapy was given BID for 7 days. The primary endpoint was safety over 6 months. Secondary endpoints included neurological (NIHSS) and functional [Barthel index and modified Rankin scale (mRS)] outcomes. Results: The study population had a mean age of 66 ± 11 years, with 21 men (58.3%), a baseline median NIHSS score of 9 (95% CI: 8-11), and a mean time to treatment of 7.3 ± 2.8 h. Analyses were conducted on an intention-to-treat basis. SAEs were reported in 9 of 16 (56.2%) patients in the control group, 3 of 10 (30%) patients in Group I (odds ratio (OR): 0.33; 95% CI: 0.06-1.78), and 2 of 10 (20%) patients in Group II (OR: 0.19; 95% CI: 0.03-1.22); only two events in one patient in Group I were attributed to the intervention treatment. Compliance with the study hypothesis was greater than 0.90 in each group. Patients treated with EGF + GHRP6 had a favorable neurological and functional evolution at both 90 and 180 days, as evidenced by the inferential analysis of NIHSS, Barthel, and mRS and by their moderate to strong effect size. At 6 months, proportion analysis evidenced a higher survival rate for patients treated with the combined therapy. Ancillary analysis including merged treated groups and utility-weighted mRS also showed a benefit of this combined therapy. Conclusion: EGF + GHRP6 therapy was safe. The functional benefits of treatment in this study supported a Phase III study. Clinical Trial Registration: RPCEC00000214 of the Cuban Public Registry of Clinical Trials, Unique identifier: IG/CIGB-845I/IC/1601.

Ingesta dietética y patrón alimentario de las mujeres en periodo de gestación y lactancia de los pueblos indígenas de Colombia. Problemática que requiere urgente atención

Objetivo: Analizar el patrón alimentario y el riesgo de deficiencia en la ingesta usual de energía y nutrientes de las mujeres gestantes y lactantes de algunos pueblos indígenas. Metodología: Estudio descriptivo transversal, con información del componente de ingesta dietética tomada del Estudio nacional de la situación alimentaria y nutricional de los pueblos indígenas de Colombia, realizado entre 2013 y 2019, que incluyó 1028 mujeres indígenas gestantes (319) y lactantes (709), de las regiones norte y sur del país. Resultados: Se encontró una proporción superior al 90 % (Desviación estándar = 0,04) de gestantes y lactantes con consumo inferior al recomendado de calorías (p= 0,038). Alrededor del 70 % de las gestantes y lactantes no consumió lácteos el día anterior a la encuesta, y 50 % no consumió frutas y verduras. Con respecto a los micronutrientes, se encontraron, en las gestantes y lactantes, altas prevalencias del riesgo de deficiencia en la ingesta de vitamina C (50,3 y 80,2 %), folatos (80,4 y 95,1 %), zinc (87,6 y 96,3 %), hierro (88,9 y 68,6 %) y calcio (87,5 y 98,5 %). Conclusión: El consumo de alimentos y nutrientes en las mujeres indígenas gestantes y lactantes es deficiente en nutrientes claves para mantener su estado de salud y proporcionar los nutrientes necesarios a su bebé, y su patrón alimentario se clasifica como no saludable.

Objective: To analyze the dietary pattern and deficiency risk in the usual energy and nutrient intake of pregnant and lactating women from some indigenous peoples. Methodology: Cross-sectional descriptive study, with information from the dietary intake component taken from the National Survey of the food and nutritional situation of indigenous peoples in Colombia, conducted between 2013 and 2019, which included 1,028 pregnant (319) and lactating (709) indigenous women from the northern and southern regions of the country. Results: A proportion higher than 90% (SD = 0.04) of pregnant and lactating women with lower than recommended calorie intake was found (p = 0.038). Around 70% of pregnant and lactating women had no any dairy products the day before the survey, and 50% did not eat fruits and vegetables. Regarding micronutrients, high prevalence of deficiency risk in the intake of vitamin C (50.3 and 80.2%), folate (80.4 and 95.1%), zinc (87.6 and 96.3%), iron (88.9 and 68.6%) and calcium (87.5 and 98.5%) was found in pregnant and lactating women. Conclusion: Food and nutrient intake in pregnant and lactating indigenous women is deficient in key nutrients to maintain their general health and provide the necessary nutrients to their babies. Their dietary pattern is considered unhealthy.

Objetivo: Analisar o padrão alimentar e o risco de deficiência na ingestão usual de energia e nutrientes das mulheres gestantes e lactantes de alguns povos indígenas. Metodologia: Estudo descritivo transversal, com informação do componente de ingesta dietética tirada do Estudo nacional da situação alimentar e nutricional dos povos indígenas da Colômbia, realizado entre 2013 e 2019, que incluiu 1028 mulheres indígenas gestantes (319) e lactantes (709) das regiões norte e sul do país. Resultados: Encontrou-se uma proporção superior a 90% (Desvio-padrão = 0,04) de gestantes e lactantes com consumo inferior ao recomendado em calorias (p = 0,038). Ao redor de 70% das gestantes e lactantes não consumiu lácteos no dia prévio à enquete, e 50% não consumiu frutas e verduras. No que se refere aos micronutrientes, acharam-se nas gestantes e lactantes altas prevalências de risco de deficiência na ingestão de vitamina C (50,3 e 80,2 %), folatos (80,4 e 95,1 %), zinco (87,6 e 96,3 %), ferro (88,9 e 68,6 %) e cálcio (87,5 e 98,5 %). Conclusão: O consumo de alimentos e nutrientes nas mulheres indígenas gestantes e lactantes é deficiente em nutrientes-chave para manter seu estado de saúde e proporcionar os nutrientes necessários para o bebê; seu padrão alimentar classifica-se como não saudável.

Exploring Microorganisms from Plastic-Polluted Sites: Unveiling Plastic Degradation and PHA Production Potential.

The exposure of microorganisms to conventional plastics is a relatively recent occurrence, affording limited time for evolutionary adaptation. As part of the EU-funded project BioICEP, this study delves into the plastic degradation potential of microorganisms isolated from sites with prolonged plastic pollution, such as plastic-polluted forests, biopolymer-contaminated soil, oil-contaminated soil, municipal landfill, but also a distinctive soil sample with plastic pieces buried three decades ago. Additionally, samples from Arthropoda species were investigated. In total, 150 strains were isolated and screened for the ability to use plastic-related substrates (Impranil dispersions, polyethylene terephthalate, terephthalic acid, and bis(2-hydroxyethyl) terephthalate). Twenty isolates selected based on their ability to grow on various substrates were identified as Streptomyces, Bacillus, Enterococcus, and Pseudomonas spp. Morphological features were recorded, and the 16S rRNA sequence was employed to construct a phylogenetic tree. Subsequent assessments unveiled that 5 out of the 20 strains displayed the capability to produce polyhydroxyalkanoates, utilizing pre-treated post-consumer PET samples. With Priestia sp. DG69 and Neobacillus sp. DG40 emerging as the most successful producers (4.14% and 3.34% of PHA, respectively), these strains are poised for further utilization in upcycling purposes, laying the foundation for the development of sustainable strategies for plastic waste management.

Boosting the Hydrodeoxygenation Activity and Selectivity of Ni/(M)-SBA-15 Catalysts by Chemical Alteration of the Support.

The influence of the acid sites in the hydrodeoxygenation of anisole performed over Ni catalysts supported on SBA-15 modified with metal oxides (Ni/M-SBA-15, M = Ti, Zr, Al, or Nb) was demonstrated. Catalysts were characterized by SEM-EDX, nitrogen physisorption, XRD, UV-visible DRS, TPR, TPD of ammonia, IR-Py, O2 chemisorption, and high-resolution transmission electron microscopy. The mesoporous structure and the hexagonal arrangement of the supports were maintained in the catalysts. Ni catalysts supported on modified M-SBA-15 exhibited a higher metal-support interaction, an increase in the acidity and, as a consequence, improved selectivity to cyclohexane. The deoxygenation reaction rate constants increased as Ni/SBA-15 < Ni/Ti-SBA-15 < Ni/Nb-SBA-15 < Ni/Zr-SBA-15 < Ni/Al-SBA-15, which is attributed to the increase in the amount and strength of acid sites, especially of the Brønsted ones, which promotes the cleavage of the C-O bond. It is also important to keep the metal/acid sites together to obtain high activity and selectivity to hydrodeoxygenated products.

Manejo del paciente con Hipertiroidismo en consulta externa de la Unidad Técnica de Endocrinología del Hospital Carlos Andrade Marín / Management of the patient with hyperthyroidism in the outpatient clinic of the Technical Unit of Endocrinology of the Endocrinology Technical Unit of the Carlos Andrade Marín Hospital

El hipertiroidismo es un trastorno caracterizado por el exceso de hormonas tiroideas. El déficit de yodo es un factor clave en dicha patología y en lugares con suficiencia del mismo se asocian a au-toinmunidad tiroidea. La prevalencia de hipertiroidismo mani-fiesto varía del 0,2% al 1,3% en áreas con suficiencia de yodo, sin embargo, esto puede variar en cada país por diferencias en umbrales de diagnóstico, sensibilidad de ensayo y población se-leccionada. Un reporte de The Third National Health and Nutri-tion Examination Survey (NHANES III) mostró que el hiperti-roidismo manifiesto se presenta en 0,7% de la población general e hipertiroidismo subclínico en el 1,7%1,2.En incidencia, la patología se asocia con la suplementación de yodo, con la mayor frecuencia en áreas de deficiencias, por au-mento de nódulos tiroideos en la población anciana, teniendo a regiones de áreas montañosas como América del Sur, África Central y suroeste de Asia dentro de este grupo. Un meta aná-lisis de estudios europeos mostró una incidencia general de 50 casos por 100000 personas/años1. En Ecuador, según los datos del Instituto Nacional de Estadísticas y Censos (INEC) del 2017, se reportaron 157 casos de hipertiroidismo, de los cuales la En-fermedad de Graves (EG) fue la causa más común, seguida por el bocio multinodular tóxico (BMNT) y finalmente el adenoma tóxico (AT) con una incidencia de 61 %, 24 % y 14 % respecti-vamente3.Los pacientes con esta patología tienen aumento de riesgo com-plicaciones cardiovasculares y mortalidad por todas las causas, siendo falla cardíaca uno de sus principales desenlaces, así el diagnóstico precoz evita estos eventos, principalmente en pobla-ción de edad avanzada.El presente protocolo se ha realizado para un correcto trata-miento de esta patología en el Hospital de Especialidades Carlos Andrade Marín (HECAM).

Hyperthyroidism is a disorder characterized by an excess of thyroid hormones. Iodine deficiency is a key factor in this pa-thology and in places with iodine deficiency it is associated with thyroid autoimmunity. The prevalence of overt hyperthyroidism varies from 0,2% to 1,3% in iodine-sufficient areas; however, this may vary from country to country due to differences in diag-nostic thresholds, assay sensitivity, and selected population. A report from The Third National Health and Nutrition Examina-tion Survey (NHANES III) showed that overt hyperthyroidism occurs in 0,7% of the general population and subclinical hyper-thyroidism in 1,7%1,2.In incidence, the pathology is associated with iodine supplemen-tation, with the highest frequency in areas of deficiencies, due to increased thyroid nodules in the elderly population, having regions of mountainous areas such as South America, Central Africa and Southwest Asia within this group. A meta-analysis of European studies showed an overall incidence of 50 cases per 100000 person/years1. In Ecuador, according to data from the National Institute of Statistics and Census (INEC) in 2017, 157 cases of hyperthyroidism were reported, of which, Graves' di-sease (GD) was the most common cause, followed by toxic mul-tinodular goiter (BMNT) and finally toxic adenoma (TA) with an incidence of 61 %, 24 % and 14 % respectively3.Patients with this pathology have an increased risk of cardiovas-cular complications and all-cause mortality, with heart failure being one of the main outcomes, so early diagnosis avoids these events, mainly in the elderly population.The present protocol has been carried out for the correct treat-ment of this pathology at the Carlos Andrade Marín Specialties Hospital (HECAM).

Rehabilitación en la enfermedad de Pompe / Pompe disease rehabilitation management

Introducción: Gracias a la nueva herramienta de tratamiento con la terapia de reemplazo enzimático en la enfermedad de Pompe, se ha reducido la mortalidad a corto plazo. Contenidos: Esta herramienta permite a los pacientes mantener la independencia funcional y la adaptación de las habilidades motrices para su participación en varios aspectos de la vida diaria. Conclusiones: El abordaje de estos pacientes debe ser multidisciplinario, para dar un manejo integral a la condición clínica de cada individuo, y procurar el tratamiento de los sistemas físicos y emocionales que se pueden ver alterados con el curso de la enfermedad: osteomuscular, cardiovascular y respiratorio, deglución, lenguaje, nutrición y psicológico, incluidos los cuidados paliativos y el manejo del dolor.

Introduction: Enzyme replacement therapy in Pompe disease reduces short-term mortality. Contents: This therapy allows patients to maintain functional independence and adaptation of motor skills for patient participation in various aspects of daily life. Conclusions: The approach with this patients should be multidisciplinary to provide comprehensive management of the clinical condition of each individual seeking treatment of the physical and emotional aspects that may be altered in the disease progression: musculoskeletal, cardiovascular, respiratory, swallowing, language, nutritional and psychological; also including palliative care and pain management.

Risk assessment and green chemistry applied to waste generated in university laboratories.

Chemical reagents have become fundamental products in daily life use, they contribute in several ways to establish a high level of social development. In the case of higher education, the use of reagents allows learning thought laboratory practices. These practices must be carried out under preventative measures, in order to avoid negative impacts on the environment and human health; this generates the need to identify and classify the chemical substances used and the waste generated. This research was developed at the Faculty of Environmental Engineering at Universidad Santo Tomás in the Villavicencio campus, the objective was to apply the concepts of Green Chemistry in the laboratory guidelines, in addition to guaranteeing the proper management of the chemical waste generated. Initially, the hazard of twenty-one (21) laboratory guides based on the Globally Harmonized System (GHS) ninth revised edition (2021) was determined. Subsequently, an update was performed by applying Green Chemistry to ten (10) of the laboratory guides that represented the greatest hazards, and finally, a manual was established for the management of chemical waste resulting from laboratory practices. The results determined that in the subject of Inorganic Chemistry the guidelines Physical and Chemical Properties of the Matter presents the highest hazard index, due to lead nitrate, which was evaluated as the most hazard reagent, because of its carcinogenicity (1B) and reproductive toxicity (1A). The proposed update to the guidelines was possible by replacing the chemical substances used in order to reduce by 24% the risk associated with them and the by 50% the use of reagents in relation to the same laboratory guidelines defined in the first stage.

Trasplante hepático en hepatitis alcohólica aguda: ¿debemos decir que no?

Alcohol liver disease is one of the main indications for liver transplantation (LT). Currently, an abstinence period <6 months is required to include a patient with alcohol liver disease on the waiting list, a period that has not been shown to reduce the risk of relapse. Alcoholic hepatitis is characterized by hepatic decompensation secondary to recent, excessive consumption of alcohol, and LT may be the option in a well-selected group of patients who do not respond to medical treatment, but due to established sobriety intervals are excluded, this requires a change in the criteria established by the committees. We propose an evaluation algorithm to consider alcoholic hepatitis unresponsive to medical treatment for LT.

La enfermedad hepática por alcohol es una de las principales indicaciones de trasplante hepático (TH). Actualmente se requiere un período de abstinencia > 6 meses para incluir a un paciente con enfermedad hepática por alcohol en lista de espera de TH, periodo que no ha demostrado disminuir el riesgo de recaída. La hepatitis aguda por alcohol se caracteriza por una descompensación hepática secundaria a un consumo de alcohol excesivo reciente, y el TH puede ser la única opción en un grupo bien seleccionado de pacientes que no responden al tratamiento médico, pero debido a los intervalos de sobriedad establecidos son excluidos, y esto requiere un cambio en los criterios establecidos por los comités. Proponemos un algoritmo de evaluación para considerar para TH la hepatitis aguda por alcohol no respondedora a tratamiento médico.

Cell-Free Filtrates (CFF) as Vectors of a Transmissible Pathologic Tissue Memory Code: A Hypothetical and Narrative Review.

Cellular memory is a controversial concept representing the ability of cells to "write and memorize" stressful experiences via epigenetic operators. The progressive course of chronic, non-communicable diseases such as type 2 diabetes mellitus, cancer, and arteriosclerosis, is likely driven through an abnormal epigenetic reprogramming, fostering the hypothesis of a cellular pathologic memory. Accordingly, cultured diabetic and cancer patient-derived cells recall behavioral traits as when in the donor's organism irrespective to culture time and conditions. Here, we analyze the data of studies conducted by our group and led by a cascade of hypothesis, in which we aimed to validate the hypothetical existence and transmissibility of a cellular pathologic memory in diabetes, arteriosclerotic peripheral arterial disease, and cancer. These experiments were based on the administration to otherwise healthy animals of cell-free filtrates prepared from human pathologic tissue samples representative of each disease condition. The administration of each pathologic tissue homogenate consistently induced the faithful recapitulation of: (1) Diabetic archetypical changes in cutaneous arterioles and nerves. (2) Non-thrombotic arteriosclerotic thickening, collagenous arterial encroachment, aberrant angiogenesis, and vascular remodeling. (3) Pre-malignant and malignant epithelial and mesenchymal tumors in different organs; all evocative of the donor's tissue histopathology and with no barriers for interspecies transmission. We hypothesize that homogenates contain pathologic tissue memory codes represented in soluble drivers that "infiltrate" host's animal cells, and ultimately impose their phenotypic signatures. The identification and validation of the actors in behind may pave the way for future therapies.

Validation of an instrument to assess food diversity in women of childbearing age in Medellín, Colombia.

OBJECTIVE: To validate a Food Diversity Questionnaire (CDA, for its name in Spanish) that identifies the prevalence of the risk of deficiency in the intake of eleven micronutrients. DESIGN: The CDA paper form, an online application for data entry and handling, was designed and compared with the 24-h recall (24HR) as a reference method. All data were processed in Personal Computer Software for Intake Distribution Estimation (PC-SIDE) v1 software. A descriptive analysis and comparisons between prevalence, concordance and reproducibility analyses were performed. SETTING: Medellín, Colombia. PARTICIPANTS: Women of childbearing age between 19 and 50 years (n 186) who worked for the Buen Comienzo programme in 2019. RESULTS: When comparing the adjusted 24HR technique and the CDA, there was no significant difference in population-level data at risk of deficiency in any micronutrient intake. However, based on individual-level data of the best linear unbiased predictor, the concordance analyses were weak, and although agreements were high according to the diagnostic performance tests, a good ability to detect deficiency was only observed in a few nutrients: vitamin A 100·0 %, Ca 98·7 %, Fe 92·8 %, folates 91·6 %, and pyridoxine 81·8 %. CONCLUSIONS: The CDA validated in this study is useful and faster at evaluating population-level data at risk of deficiency in the intake of Ca, Fe, Zn, thiamine, riboflavin, niacin, pyridoxine, folates, vitamin B12, vitamin C and vitamin A. Based on individual-level data, a good ability to detect deficiencies was observed in the intake of vitamin A, Ca, Fe, folates and pyridoxine.

Bone Disease and Liver Transplantation: A Review.

Liver transplantation is currently the most effective and almost routine treatment for chronic and acute liver diseases. The survival of transplanted patients has increased exponentially, which has led to more knowledge of the long-term complications secondary to the underlying pathology or the various treatments that must be followed. Bone metabolic disease is a chronic complication of liver transplantation that inhibits quality of life. The factors that contribute to the development of bone disease are different according to the various etiologies of liver damage. All patients should be examined for osteoporosis risk factors because the incidence of new fractures in transplant patients is higher during the first year after transplantation, reflecting the greater bone loss during this time. This article outlines a proposal for a treatment algorithm; we propose that pharmacologic therapy in patients post liver transplant should first consider the diagnosis of osteoporosis by bone mineral density, the patient's personal and family history of spine and femoral neck fractures, and the use glucocorticoids (dose and time) until a tool is available that allows the best estimation of the fracture risk in this population of patients.

Percolation-intercropping strategies to prevent dissemination of phytopathogens on plantations.

Phytophthora is one of the most aggressive and worldwide extended phytopathogens that attack plants and trees. Its effects produce tremendous economical losses in agronomy and forestry since no effective fungicide exists. We propose to combine percolation theory with an intercropping sowing configuration as a non-chemical strategy to minimize the dissemination of the pathogen. In this work, we model a plantation as a square lattice where two types of plants are arranged in alternating columns or diagonals, and Phytophthora zoospores are allowed to propagate to the nearest and next-to-nearest neighboring plants. We determine the percolation threshold for each intercropping configuration as a function of the plant's susceptibilities and the number of inoculated cells at the beginning of the propagation process. The results are presented as phase diagrams where crop densities that prevent the formation of a spanning cluster of susceptible or diseased plants are indicated. The main result is the existence of susceptibility value combinations for which no spanning cluster is formed even if every cell in the plantation is sowed. This finding can be useful in choosing a configuration and density of plants that minimize damages caused by Phytophthora. We illustrate the application of the phase diagrams with the susceptibilities of three plants with a high commercial value.

Inequalities in food consumption the Colombian households: Results from the National Survey of Nutritional Status / Desigualdades en el consumo de alimentos en hogares colombianos: Resultados de la Encuesta Nacional de Situación Nutricional / Desigualdades no consumo de alimentos em lares colombianos: Resultados da Enquete Nacional de Situação Nutricional

Abstract Introduction: adverse socioeconomic conditions may cause food intake characterized by inequality that derives in malnutrition increases. Objective. To identify inequalities in food consumption among the Colombian population according to socioeconomic status and the food security classification for households. Methods. The data were obtained from the 2005 National Survey of Nutritional Status, and the analysis used the first 24-hour recall n=39,413 Colombians. The statistical analysis took into account descriptive statistics and 95% confidence intervals. A multivariate analysis was performed through multinomial logistic regression models, with each of the food groups as a dependent variable. Finally, a latent class analysis was performed to understand the heterogeneity of the inequalities in food consumption in the households. Results. Low-socioeconomic status households showed higher consumption of cereals, tubers and plantains, non-alcoholic beverages, and fats. I contrast, higher socioeconomic status households showed higher consumption of dairy products, fruit, vegetables, and sugars/sweets. The food security classification found that food-secure households had a higher consumption of meat, dairy, vegetables, fruit, and sugars/sweets. Households classified as food-insecure showed a higher consumption of cereals, tubers and plantains, and non-alcoholic beverages. The consumption of tubers and plantains showed a clear social gradient, in higher socioeconomic status there was lower consumption probability of those products. Conclusion. There are inequalities in food consumption in Colombia according to socioeconomic status and the food security classification; therefore, people and families with the most unfavorable socioeconomic status have diets with less nutritional value.

Resumen Objetivo: Identificar las inequidades en el consumo de alimentos según nivel socioeconómico y clasificación de seguridad alimentaria de los hogares colombianos. Métodos: Los datos provienen de la Encuesta Nacional de la Situación Nutricional de 2005, y se utilizó el primer recordatorio de 24 horas n=39,413 colombianos. El análisis estadístico tuvo en cuenta estadística descriptiva e intervalos de confianza del 95%. Se realizó un análisis de regresión logística multinomial, con cada uno de los grupos de alimentos como una variable dependiente. Finalmente, se realizó un análisis de clases latentes para capturar la heterogeneidad de las inequidades en el consumo de alimentos en los hogares. Resultados: Los hogares clasificados con un nivel socioeconómico bajo mostraron un mayor consumo de cereales, tubérculos/plátanos, bebidas no alcohólicas y grasas. Por otro lado, se observó que un nivel socioeconómico alto conllevó un mayor consumo de lácteos, frutas, verduras y azúcares/postres. Según clasificación de seguridad alimentaria, los hogares considerados en seguridad tenían un mayor consumo de carne, lácteos, verduras, frutas y azúcares/postres. Los hogares clasificados en inseguridad alimentaria mostraron mayor consumo de cereales, tubérculos/plátanos, y bebidas no alcohólicas. El consumo de tubérculos y plátanos mostró un gradiente social, con menor probabilidad de consumo a mayor nivel socioeconómico. Conclusión: Existen inequidades en el consumo de alimentos en Colombia según nivel socioeconómico y clasificación de seguridad alimentaria, por tanto, las personas y familias en estado socioeconómico más desfavorable tienen dietas con menor valor nutricional.

Resumo Objetivo: Identificar as desigualdades no consumo de alimentos segundo o nível socioeconômico e classificação de segurança alimentar dos lares colombianos. Métodos: Os dados provêm da Enquete Nacional da Situação Nutricional de 2005, e se utilizou o primeiro lembrete de 24 horas n=39,413 colombianos. A análise estatístico levando em conta Estatísticas descritiva e intervalos de confiança de 95%. Realizou-se uma análise de regressão logística multinominal, com cada um dos grupos de alimentos como uma variável dependente. Finalmente, realizou-se uma análise de classes latentes para capturar a heterogeneidade das desigualdades no consumo de alimentos nos lares. Resultados: Os lares classificados com um nível socioeconómico baixo amostraram um maior consumo de cereais, tubérculos/ banana da terra, bebidas não alcoólicas e gorduras. Por outro lado, observou-se que um nível socioeconómico alto tem um maior consumo de lácteos, frutas, verduras e açúcares/sobremesas. Segundo a clasificação de segurança alimentar, os lares considerados em segurança tinham um maior consumo de carne, lácteos, verduras, frutas e açúcares/sobremesas. Os lares classificados em insegurança alimentar evidenciaram maior consumo de cereais, tubérculos/banana da terra, e bebidas não alcoólicas. O consumo de tubérculos e banana da terra evidenciou uma desigualdade social, com menor probabilidade de consumo no nível socioeconômico mais alto. Conclusão: Existem desigualdades no consumo de alimentos na Colômbia de acordo com o nível socioeconômico e classificação de segurança alimentar. Deste modo, as pessoas e famílias em condições socioeconômicos mais desfavoráveis têm dietas com menor valor nutricional.

Insulin Resistance at the Crossroad of Alzheimer Disease Pathology: A Review.

Insulin plays a major neuroprotective and trophic function for cerebral cell population, thus countering apoptosis, beta-amyloid toxicity, and oxidative stress; favoring neuronal survival; and enhancing memory and learning processes. Insulin resistance and impaired cerebral glucose metabolism are invariantly reported in Alzheimer's disease (AD) and other neurodegenerative processes. AD is a fatal neurodegenerative disorder in which progressive glucose hypometabolism parallels to cognitive impairment. Although AD may appear and progress in virtue of multifactorial nosogenic ingredients, multiple interperpetuative and interconnected vicious circles appear to drive disease pathophysiology. The disease is primarily a metabolic/energetic disorder in which amyloid accumulation may appear as a by-product of more proximal events, especially in the late-onset form. As a bridge between AD and type 2 diabetes, activation of c-Jun N-terminal kinase (JNK) pathway with the ensued serine phosphorylation of the insulin response substrate (IRS)-1/2 may be at the crossroads of insulin resistance and its subsequent dysmetabolic consequences. Central insulin axis bankruptcy translates in neuronal vulnerability and demise. As a link in the chain of pathogenic vicious circles, mitochondrial dysfunction, oxidative stress, and peripheral/central immune-inflammation are increasingly advocated as major pathology drivers. Pharmacological interventions addressed to preserve insulin axis physiology, mitochondrial biogenesis-integral functionality, and mitophagy of diseased organelles may attenuate the adjacent spillover of free radicals that further perpetuate mitochondrial damages and catalyze inflammation. Central and/or peripheral inflammation may account for a local flood of proinflammatory cytokines that along with astrogliosis amplify insulin resistance, mitochondrial dysfunction, and oxidative stress. All these elements are endogenous stressor, pro-senescent factors that contribute to JNK activation. Taken together, these evidences incite to identify novel multi-mechanistic approaches to succeed in ameliorating this pandemic affliction.

Affinin and hexahydroaffinin: Chemistry and toxicological profile.

The present work aimed to determine the safety parameters of two new alkamides, affinin and hexahydroaffinin, with antinociceptive activity. To predict the preliminary acute toxicity, we used the acute and subchronic toxicity (50 mg/kg, orally [po]) in Swiss Webster mice. Genotoxicity assayed via analysis of cell micronuclei of the femoral bone marrow in mice; at the same time, metabolic parameters determined from peripheral blood samples. Furthermore, to discard the neuropharmacological effects, we assessed the ambulatory activity in mice to determine the possible effects in the central nervous system. Finally, we used capsaicin as a positive control of alkamides. According to our results, hexahydroaffinin (LD50 ≥ 5,000 mg/kg, po) is significantly less noxious than affinin (LD50 = 1,442.2 mg/kg, po) or capsaicin (LD50 = 489.9 mg/kg, po). In subchronic administration, we did not observe any changes in hematological or biochemical parameters in any compound analyzed from peripheral blood samples. Finally, the data from the genotoxicity assay showed micronuclei formation in 28%, 5%, and 3% of mice in the capsaicin, affinin, and hexahydroaffinin groups, respectively. With the results obtained in the present investigation, we suggest that affinin and hexahydroaffinin are not only useful candidates for possible new drugs but also safe compounds.

Cellular Senescence as the Pathogenic Hub of Diabetes-Related Wound Chronicity.

Diabetes is constantly increasing at a rate that outpaces genetic variation and approaches to pandemic magnitude. Skin cells physiology and the cutaneous healing response are progressively undermined in diabetes which predisposes to lower limb ulceration, recidivism, and subsequent lower extremities amputation as a frightened complication. The molecular operators whereby diabetes reduces tissues resilience and hampers the repair mechanisms remain elusive. We have accrued the notion that diabetic environment embraces preconditioning factors that definitively propel premature cellular senescence, and that ulcer cells senescence impair the healing response. Hyperglycemia/oxidative stress/mitochondrial and DNA damage may act as major drivers sculpturing the senescent phenotype. We review here historical and recent evidences that substantiate the hypothesis that diabetic foot ulcers healing trajectory, is definitively impinged by a self-expanding and self-perpetuative senescent cells society that drives wound chronicity. This society may be fostered by a diabetic archetypal secretome that induces replicative senescence in dermal fibroblasts, endothelial cells, and keratinocytes. Mesenchymal stem cells are also susceptible to major diabetic senescence drivers, which accounts for the inability of these cells to appropriately assist in diabetics wound healing. Thus, the use of autologous stem cells has not translated in significant clinical outcomes. Novel and multifaceted therapeutic approaches are required to pharmacologically mitigate the diabetic cellular senescence operators and reduce the secondary multi-organs complications. The senescent cells society and its adjunctive secretome could be an ideal local target to manipulate diabetic ulcers and prevent wound chronification and acute recidivism. This futuristic goal demands harnessing the diabetic wound chronicity epigenomic signature.

Disparities in fertility knowledge among women from low and high resource settings presenting for fertility care in two United States metropolitan centers.

BACKGROUND: Few studies have examined health literacy and fertility knowledge among women from low income, socio-culturally diverse communities presenting for fertility care in the United States. Our study sought to examine demographic predictors of fertility-related knowledge among infertile women from low and high-resource communities in two major metropolitan centers in the United States. METHODS: Fertility Knowledge Assessments were administered to women presenting for fertility care at county medical centers serving low-resource, largely immigrant patients and to women from largely affluent populations presenting to comprehensive fertility centers in two cities. The influence of demographic predictors on fertility knowledge was examined through regression analysis. RESULTS: A total of 143 women were included in our analysis. In the county hospital/low resource clinic (LR, n = 70), the mean age was 32.8 ± 6.1 years vs 35.0 ± 5.0 years in the fee-for-service/high resource clinic (HR, n = 73). Among the LR patients, 74% were immigrants, 71% had an annual income <$25,000 and 52% had completed high school. Among HR patients, 36% were immigrants, 60% had an annual income >$100,000, and 95% had some college or above. On average, women from HR settings scored 3.0 points higher on the Fertility Knowledge Assessment than their LR counterparts (p < 0.001). Upon multivariate analysis, education level remained the sole independent factor associated with fertility knowledge assessment score (p < 0.001). Stratifying by resource level revealed that income was highly associated with fertility knowledge (p < 0.01) among high resource individuals even when adjusting for education level. CONCLUSIONS: Women from low resource, largely immigrant communities, seeking fertility care have greater disparities in fertility knowledge and lower health literacy compared to women from high resource clinical settings. Further studies are needed to understand these barriers and to develop targeted inventions to lower disparities and improve care for these vulnerable populations.

Consumo de bebidas azucaradas y con azúcar añadida y su asociación con indicadores antropométricos en jóvenes de Medellín (Colombia) / Consumption of sugary drinks and sugar added to beverages and their relationship with anthropometric indicators in young people from Medellín (Colombia)

Introducción: a nivel mundial se reporta una alta prevalencia de sobrepeso y obesidad en los niños y jóvenes; la etiología es multicausal e influyen factores ambientales, culturales y de hábitos alimentarios, como es el consumo de bebidas azucaradas y azúcar añadido, que promueven el exceso de peso y el riesgo de enfermedades crónicas. Objetivo: identificar la relación entre la cantidad ingerida de bebidas azucaradas (BA) o con azúcar añadido (AA) y el estado nutricional de los jóvenes. Métodos: estudio transversal realizado en 596 individuos de entre 10 y 18 años de edad. La evaluación de la ingesta dietética se realizó por medio del Recordatorio de 24 horas (R24H); para cada uno de los individuos se consideró el mejor predictor lineal insesgado (MPLI) de energía y el %AMDR (acceptable macronutrient distribution range) de los carbohidratos (CHO) totales y los CHO simples; el estado nutricional se clasificó según el puntaje Z del índice de masa corporal (IMCz) y el porcentaje de grasa corporal (%GC). Se determinó la asociación con la correlación de Spearman, la U de Mann-Whitney, la prueba de Kruskal-Wallis y un modelo de regresión cuantílica. Resultados: los jóvenes de estrato socioeconómico medio-bajo presentaron un mayor consumo de AA (p = 0,0001); los jóvenes con estado nutricional adecuado presentaron un mayor consumo de AA (p = 0,011) y de energía (p = 0,0001), y aquellos con estado nutricional excesivo ingerían una mayor cantidad de BA (p = 0,025) con un mayor %AMDR de CHO simples (p = 0,045). Conclusiones: el desarrollo de sobrepeso no estaba relacionado con la ingesta excesiva de energía sino con el consumo de bebidas azucaradas y el aporte de carbohidratos simples a la energía total

Introduction: worldwide, there is a high prevalence of overweight and obesity in children and young people; the etiology is multicausal and influences include environmental, cultural and eating habit factors such as the consumption of sugary drinks and added sugar, which promote excess weight and risk of chronic diseases. Objective: to identify the relationship between the amount of ingested sugary drinks (BA) or added sugar (AA) and the nutritional status of young people. Methods: cross-sectional study carried out in 596 individuals aged between 10 and 18 years; the evaluation of dietary intake was made using a Reminder 24 hours (R24H); for each subject the Best Linear Unbiased Predictor (BLUP) of energy, and %AMDR (Acceptable Macronutrient Distribution Range) for total carbohydrates (CHOs) and simple CHOs were considered; nutritional status was classified according to the Body Mass Index (BMI) Z-score and percentage of body fat (%BF). Association was determined using Spearman's correlation, Mann-Whitney U-test, Kruskal-Wallis test, and a quantile regression model. Results: young people with medium-low socioeconomic status had higher AA consumption (p = 0.0001); young people with an adequate nutritional status had higher AA (p = 0.011) and energy consumption (p = 0.0001), and those with excess nutritional status ingested a greater amount of BA (p = 0.025) and had a greater %AMDR for CHOs (p = 0.045). Conclusions: the development of overweight was not related to excessive energy intake but to consumption of sugary drinks and the contribution of simple carbohydrates to total energy

Prevalencia de parasitismo intestinal y sus factores asociados en publicaciones indexadas de colombia: revisión sistemática 2000-2017

Introducción. En Colombia, las parasitosis intestinales constituyen un problema de salud pública poco investigado (o invisibilizado), a pesar de su relevancia como trazador de pobreza. Objetivo. Analizar la prevalencia de parasitismo intestinal y sus factores asociados en publicaciones indexadas de Colombia 1990-2017. Métodos. Revisión sistemática de la literatura científica a partir de la aplicación de un protocolo ex ante de selección de artículos con 40 estrategias, según las fases de identificación, tamización, elección e inclusión de Prisma. Se garantizó la reproducibilidad de la selección de los artículos y la extracción de la información. Se evaluó la calidad metodológica con la guía Strobe. Se estimaron prevalencias generales y específicas según agentes parasitarios, etnia y edad. Resultados. Se incluyeron 20 estudios con 4.226 sujetos, principalmente de Antioquia, niños y población mestiza. La prevalencia general fue 65,9% (IC de 95% = 64,5 - 67,4), con un 38,2% (IC de 95% = 36,3 - 40,0) de poliparasitismo y 19,1% (IC de 95% = 16,2 - 21,9) por especies patógenas. Las infecciones más prevalentes corresponden a Blastocystis hominis con 34,0% (IC de 95 % = 32,5 - 35,6), E. coli 27,4% (IC de 95% = 25,8 - 29,0), E. nana 26,2% (IC de 95% = 24,6 - 27,7) y E. histolytica/dispar/moshkovski 15,1% (IC de 95% = 13,9 - 16,3); mientras que las especies de menor magnitud fueron E. hominis, C. cayatenensis, E. vermicularis y T. hominis. La infección fue 23,6% mayor en niños indígenas en comparación con niños mestizos; en adultos no se registraron diferencias estadísticas según la etnia. Conclusión. Las investigaciones publicadas en revistas indexadas refieren una elevada prevalencia de parasitismo intestinal global, así como la alta frecuencia de algunas especies. Para el caso colombiano, las publicaciones refieren a múltiples factores asociados con la pobreza, las condiciones materiales de vida y los aspectos sociodemográficos; aunque solo se pudo metaanalizar el mayor riesgo de la población de niños e indígenas.

Introduction: In Colombia, intestinal parasitic infections are a public health problem which has little research, even with its relevance as a poverty tracer. Objective: To analyze the prevalence of intestinal parasitism and associated factors in indexed papers in Colombia 1990-2017. Method: Systematic revision of scientific literature through carrying out an ex ante protocol to select articles with 40 strategies, according to identification phases, screening, election and inclusion of prism. Reproducibility of article selection and information extraction was guaranteed. Methodological quality was evaluated with the Strobe guide. General and specific prevalences were estimated according to parasitic agents, ethnicity and age. Results: 20 studies with 4.226 subjects were included, mainly in Antioquia, in Mestizo children. The general preva- lence was 65.9% (CI of 95% = 64.5 - 67.4), with a 38.2% (CI of 95% = 36.340.0) of polyparasitism and 19.1% (CI of 95%=16-2 -21.9) for pathogenic species. Most prevalent infections are Blastocystis hominis with a 34.0% (CI of 95% = 32.5 - 35.6), E. coli 27.4% (CI of 95% = 25.8 - 29.0), E. nana 26.2% (CI of 95% = 24.6 - 27.7) and E. histolytica/dispar/moshkovski 15.1 % (IC of 95% = 13.9 - 16.3); while less species where E. hominis, C. cayatenensis, E. vermicularis y T. hominis. The infection was 23.6% higher in indigenous children, compared to Mestizo children. Adults did not register any statistical difference in terms of ethnicity. Conclusion: Research published in indexed journals show an elevated prevalence of global intestinal parasitism, as well as the high frequency of certain species. In the case of Colombia, papers refer to multiple factors associated to poverty, material life conditions and sociodemographic aspects. It was only possible to metaanalyze the risk of children and indigenous children.

Introdução: na Colômbia, as parasitoses intestinais constituem um problema de saúde pública pouco pesquisado ou invisibilizado, embora sua relêvancia como definidor de pobreza. Objetivo: analisar a prevalência de parasitose intestinal e seus fatores associados em publicações indexadas da Colômbia 1990-2017. Métodos: revisão sistemática da literatura científica a partir da aplicado de um protocolo ex ante de seleção de artigos com 40 estratégias, segundo as fases de identificação, rastreio, escolha e inclusão de Prisma. Foi garantida a reprodutibilidade da seleção dos artigos e a extração da informado. Foi evidenciada a qualidade metodológica com o guia Strobe. Foram estimadas prevalencias gerais e específicas segundo agentes parasitários, etnia e idade. Resultados: foram incluídos 20 estudos com 4.226 sujeitos, principalmente de Antioquia, Colômbia, crianzas e população mestiza. A prevalência geral foi 65,9% (IC de 95% = 64,5 - 67,4), com 38,2% (IC de 95% = 36,3 - 40,0) de poliparasitose e 19,1% (IC de 95% = 16,2 - 21,9) por espécies patógenas. As infecções mais prevalentes correspondem a Blastocystis hominis com 34,0% (IC de 95% = 32,5 - 35,6), E. coli 27,4% (IC de 95% = 25,8 - 29,0), E. nana 26,2% (IC de 95% = 24,6 - 27,7) e E. histolytica/dispar/moshkovski 15,1% (IC de 95% = 13,9 - 16,3); enquanto as espécies de menor magnitude foram E. hominis, C. cayatenensis, E. vermicularis e T. hominis. A infecção foi 23,6% maior em crianzas indígenas em comparação com crianças mestizas; em adultos, nao foram registradas diferenças estatísticas segundo a etnia. Conclusão: as pesquisas publicadas em revistas indexadas referem elevada prevalência de parasitose intestinal global, bem como alta frequência de algumas espécies. Para o caso colombiano, as publicações apresentam múltiplos fatores associados com a pobreza, com as condições materiais de vida e com os aspectos sociodemográficos, embora somente tenha sido materializado o maior risco da população de criançãs e indígenas.